A 78-year-old female comes to the clinic for a physical exam…
A 78-year-old female comes to the clinic for a physical examination. She is accompanied by her daughter and looks to her daughter to answer questions during the interview. She was diagnosed with early Alzheimer’s disease 2 years ago, and her daughter would like her current mental status evaluated. You ask the patient her daughter’s name, and she answers correctly. You ask her the date and time, and she answers incorrectly. Her daughter says that her mom seems frustrated and confused because she can’t seem to speak as well or understand things the way she used to. Her daughter says that this morning, for example, her mom was trying to say “put the car in the garage” and it came out as “put the train in the house.” You hand the patient a pencil and ask her if she knows what it is. She replies with, “Is it a stick?” You ask the patient to put on a patient gown, and she does not know how to perform the task. These are examples of disorientation to time and: